Airway management induces stress and fear in the heart of many Critical Care practitioners. In a high pressure situation, it’s easy to falter on the see-saw of demand vs. ability. Rich argues that in difficult airway management, we are hindered by: complex algorithms, anecdotal expertise and the negative perception of the task as ‘undoable’ and the downplaying of our abilities. In crisis, we need simple! Rich discusses the need to redefine the priorities of the airway (away from ‘find the vocal ...
Jun 07, 2016•23 min
Andy Naidech gives a fascinating and powerful short talk on controversies in management of aneurysmal subarachnoid haemorrhage, followed by discussion from the panel of experts and questions from the crowd. This was recorded at the neuro workshop for SMACC Chicago and was a very popular session.
Jun 03, 2016•1 hr 6 min
In this hypothetical panel discussion, our protagonists have just started work at the Utopia Trauma Centre – a state of the art facility that is world renowned for its excellence in trauma care, research and teaching … Our panel includes a social worker in intensive care, a senior intensivist and director of training for ICU, an emergency physician and director of ‘physician leadership development’, a trauma surgeon, an ICU and flight nurse, a consultant high performance coach for the institutio...
Jun 03, 2016•1 hr 36 min
Simon Carley has us asking ourselves some confronting questions about our abilities in his SMACC Chicago talk ‘Are You as Good as You Think?’. Carley has us delve into our confidence, competencies and whats makes for a good self learning environment. Initially Carley asks how good we think we are at driving? He then sites studies of Australian and European driver responses stating that 93% of Aussies and 69% europeans rate themselves as above average drivers. In using the example Carley suggests...
May 31, 2016•31 min
Cliff Reid unites our passion of Critical Care in his SMACC Chicago talk Advice to Young Resuscitationist - It’s up to us to Save the World. Talking us through his advice to his former younger self, Reid sights mistakes, case examples, and essentially provides us with invaluable tips to nudge us along to Resus Mastery. Reid offers the following advice to his former, younger self; Your career and speciality is a journey and you chose your destination: Don’t be defied by the expectations of one ch...
May 31, 2016•31 min
Simon Finfer has spent his career managing patients with traumatic brain injury nad has watched treatment fads come and go. He's also taken part in some of the best and biggest clinical trials in this area which give him a unique perspective on why we do what we do in managing this devastating but common condition. In the contraints of 15 minutes, he'll make you think and hopefully question your own practice!
May 27, 2016•24 min
Imogen Mitchell’s SMACC Chicago talk 'Morphing the Recalcitrant Clinician’ talks us through the steps to engage the reluctant physician when implementing change. Imogen initally touches on the stages of physician engagement from aversion, to apathy, to engaged and then outlines the steps to morphing the reluctant physician. 1. Seek out a clinical champion 2. Establish a common purpose/vision 3. Standardise what is standardisable 4. Communication, communication, communication 5. Work out barriers...
May 26, 2016•30 min
David Juurlink SMACC Chicago talk 'Drug Interactions That Can Kill (and How to Avoid Them)’ takes us on a journey of drug interactions, case studies, and avoidance strategies. Juurlink starts by educating us on the two different drug-drug interactions (DDI) - effects of one drug altered by the use of another . First of which is Pharmacokinetic where by one drug alters the level of another, the second Pharmacodynamic being no change in drug levels, and uses this as a basis for his following case ...
May 24, 2016•31 min
Rick Body’s SMACC Chicago talk 'Is compassion a Patients Right?' takes us on a journey of emotions in critical care. Starting with his rendition of john Lennons ‘Love’. Body, explains the origin of the word compassion - a move to act based on someone else suffering, a sharing of suffering with. Body, initially focuses on a study conducted within his hospital of 125 patients, who were interviewed when admitted to their emergency department and when they where discharged. From the study it was dep...
May 24, 2016•31 min
Andrew Healey takes us on an exploration of the early phases of donor management in ICU and Emergency Medicine in his heart felt SMACC Chicago talk Optimizing the Care of the Organ Donation Patient. Which focuses on the processes of managing donor patients and their families, while they ride their ICU/ ED journey through to organ donor. Healey summarises his talk into four main points: 1. Set families up to make the right decisions - be it with end of life care or organ donation. 2. Preserve the...
May 19, 2016•31 min
Jeremy Cohen took us on an Adrenal Function journey at SMACC Chicago with his talk Raging Hormones in Critical Care. Cohen explores the natural roll of cortisol in the human body, various schools of thought and recent research in the areas of sepsis and cortisol resistance.
May 17, 2016•31 min
Trauma is Risky Business Deborah Stein SMACC Chicago talk Trauma is Risky Business - delves into the risk patients and physicians undergo when treating or being treated for Trauma. Stein’s speaks of the Risk Benefit Determination that physicians make daily and how this is used to best answer on going questions such as; can a patient have?, how do we care for this patient? and how do we best make all the these decisions?. Stein’s suggests a thorough Risk Benefit Determination will include: # Anal...
May 17, 2016•31 min
Walter Eppich engages us on the topic of Interprofessional Communication: Challenges and Opportunities. Eppich describes communication as the engine of learning - providing it is coming from a psychologically 'safe' environment free from humiliation and punishment. Eppich characterises a psychologically safe environment being; an environment where people can speak up with idea, questions and mistakes without being fearful of being wrong and stresses when communication breaks down, patient safety...
May 12, 2016•31 min
Summary by: Rosy Wang Lactate has been viewed as a byproduct of anaerobic metabolism and an indicator of tissue hypoperfusion since the 1900s. This theory is still widely believed. Paul busts the myths surrounding lactic acidosis, anaerobic metabolism, tissue hypoxia and the role of lactate in sepsis. Key take-away facts include: - The production of lactate actually consumes hydrogen ions. Lactic acidosis is really lactic alkalosis. - Lactate is produced physiologically and is a precursor for gl...
May 10, 2016•31 min
Summary By: Rosy wang You don’t have to be Bear Grylls to stay alive in the wild. Remember the rule of three - you can live 3 minutes without air, 3 hours without shelter, 3 days without water and 3 weeks without food. The two biggest killers in the wild are cold and heat. Justin discusses the physiology of our body’s responses to cold and heat and the pathophysiology of hypo- and hyperthermia. He also talks about the simple of ways of preventing cold and heat injury, including staying dry, addi...
May 10, 2016•31 min
Kath Maitland takes the perspective that we should be cautious with how we give IV fluids. She argues that the underlying physiological evidence supporting the benefits of giving fluids is not there. The findings of the FEAST study are clear. Kath describes how during FEAST, the administration of fluids made the children look better, and improved the recorded physiological parameters. However these surrogate outcomes did not translate to a mortality benefit - fluid boluses were associated with i...
May 03, 2016•31 min
The Mystery of MODS Summary By: Oli Flowers Mervyn Singer entertains the SMACC crowd with tales of MODS (Multi Organ Dysfunction Syndrome). With videos of Raquel Welch, stories from the Battle of Trafalgar and lessons from evolution, he makes us think about the important physiology underlying critical illness. This lecture precedes the latest SIRS definition and really puts them into context and leads on to the promise of precision medicine.
May 03, 2016•31 min
Scott Weingart's lecture at SMACC-Chicago was on OODA loops and the supremacy of System I for resuscitation. Check more here
Apr 28, 2016•39 min
How to Diagnose Dying A patient's death maybe certain but the timing isn’t. Ashley Shreves talk is on the difficult subject of dying, and how best to understand and help diagnose when the battle is lost. Shreves discusses the correlating patterns present in the functional decline in end of life patients, with particular reference to the type of disease a patient is suffering from. Shreves suggests, that understanding these patterns is paramount to understanding the care and medical intervention ...
Apr 26, 2016•31 min
Selective Aortic Arch Perfusion - Summary by: Jim Manning Selective Aortic Arch Perfusion (SAAP) is an endovascular-extracorporeal perfusion resuscitation technique designed specifically to treat cardiac arrest. SAAP involves the blind insertion of a large-lumen balloon occlusion catheter into the descending thoracic aortic arch via a femoral artery. With the SAAP catheter balloon inflated in the thoracic aorta, the heart and brain are relatively isolated for resuscitative perfusion through the ...
Apr 25, 2016•31 min
Historical prospective provides a great appreciation and understanding of Prehospital Medicine. Stefan cleverly highlights the journey of a specialty from its roots on the battlefield to the present day, where prehospital medicine has not only begun to influence, but also dictate, in hospital medicine. A brief and fascinating look at "How far we've come”.
Apr 21, 2016•31 min
PHARM Physician, Per Bredmose, provides an in-depth look at Ketamine in the prehospital setting. Per discusses the uses, benefits and potential complications of Ketamine, providing tips and tricks from his wealth of experience.
Apr 19, 2016•30 min
Dr. Karel Habig of Sydney HEMS, leads a global panel in the discussion of the retrieval of patient with a difficult airway in a rural ED. Additional discussion surrounds the capabilities of HEMS services around the world. Participants include: Dr. Geoff Healy, Dr. Stephen Hearns, Dr. Craig Bates, Dr. Mike Abernethy, Dr. Minh Le Cong, Crystal Upshaw.
Apr 19, 2016•31 min
Justin Bowra - The elephant in the living room Justin Bowra takes a break from ultrasound to broach the uncool but crucial subject of health care economics. Health care spending make up a large proportion of the budgets of OECD nations, and it is increasing in relation to GDP. This is an unsustainable situation and something has got to give. In part 1 of Justin’s talk, he asks the question, where is the money going? The commonly asserted points of the aging population, better medical treatments,...
Apr 14, 2016•24 min
Tom Bleck - Subarachnoid haemorrhage: what matters? Tom Bleck gives an overview of the pertinent facts regarding the complications and management of aneurysmal subarachnoid haemorrhage (SAH). The complications of aneurysmal SAH can be divided into immediate, early and late. The risk of re-bleeding is maximal on the first day, it is fatal in 75% of patients and the best management is to secure the aneurysm by coiling or clipping. Blood pressure control is utilised widely but parameters are arbitr...
Apr 12, 2016•23 min
Dr. Brian Burns of Sydney HEMS, facilitates a global discussion on blunt abdomino-pelvic trauma 30 minutes away from ED, leading this incredible panel of experts on a hypothetical trauma case. Participants include: Dr Gareth Grier, Dr Howie Mell, Dr Thomas Dolven, Derek Sifford, NREMT-P, Dr Clare Richmond.
Apr 12, 2016•31 min
Veteran Airforce Pararescueman turned critical care paramedic, Mike Lauria discusses the
Apr 08, 2016•18 min
Rob MacSweeney and Paul Marik debate whether the assessment of fluid responsiveness in the resuscitation of patients with shock a waste of time? Both Marik and MacSweeney agree that many of the traditional methods of assessing patients volume status are flawed and of no value. Marik goes on to argue that the only clinically meaningful outcome that we should measure in response to a fluid challenge is Stoke Volume. In at least 50% of patients there is no improvement in stroke volume and further t...
Apr 05, 2016•36 min
Pretty much everything I learned as a resident in terms of the sequencing of airway management in ED has changed over the past 15 years. No longer is there simply RSI or stick a laryngoscope in with nothing and use pure brute force to intubate a patient; we have a host of different options and pathways when approaching airway management in the emergency department. This lecture discusses some of these updated ways of getting from a sick patient requiring airway management to a tube between the c...
Apr 05, 2016•28 min
Daniel Kornhall's is an introduction to snow avalanche physiology and the realities of mountain rescue. Dying in an avalanche is an extremely rare cause of death but for us who live in mountain regions and who enjoy winter mountain sports it is a thing that needs to be dealt with. The overall mortality in avalanche incidents is roughly 20% but this increases to 50% in the buried victims, which is why my talk, and most avalanche medicine, focuses on the buried victims. Asphyxia causes the vast ma...
Mar 31, 2016•23 min
